Recent years have seen trash piled high in the streets of Beirut, which presents a jarring contrast to the cultured and cosmopolitan image of Lebanon’s capital city as a jewel by the Mediterranean Sea. The visibility of the city’s waste management issues spiked in 2015, when the government closed down the Naameh landfill site and trash began to accumulate in the streets, but the roots of what evolved to become an alarming public health crisis date to the 1990s. Poor government contract decisions and companies interested in their lucrative profits have created a problem analysts say is likely to linger for years, while public health and environmental activists argue that Lebanon has no more time to lose.

Beginning two decades ago, Beirut authorities contracted with Averda, a waste management company headquartered in Dubai with operations in countries including Angola, Morocco and South Africa. The parent company’s Sukleen and Sukomi brands collected the trash in Beirut under an agreement that provided a monopoly on services at rates twice as high as what the municipality might charge, according to the Lebanese Center for Policy Studies. A lack of transparency meant that contract details were shielded from public scrutiny and costs were high, although still in line with World Bank calculations.

Beirut has awarded a new contract to in a venture with a Turkish provider, but that doesn’t resolve the land issues forcing an even greater shift to incineration facilities that Lebanese activists have been protesting for two decades – and now, in an era of climate urgency. In December 2017, Lebanese Environment Minister Tarek Khatib denied any trash crisis in response to a new Human Rights Watch report, one of many focused on Beirut trash. Incredibly, at the same time, his own ministry website features a 2016 study by American University of Beirut scientists that describes an ‘enormous’ waste crisis with health risks spiking 400 percent for those who work near landfills or trash burn sites.

The Bourj-Hammoud-Jdeideh and Ghadir River (Costa Brava) landfills, opened to replace Naameh in 2016, are expected to close by 2020. In a do-nothing scenario, that will put 57 percent of waste in dumps. In order to cope with mountains of trash, Lebanese burn it. In addition to informal dumping and burning, the government plans to extend the use of incinerators but those plans run counter to the Air Quality Management Plan released by Lebanese officials in December 2017. With more than 300 open dumps, very toxic and carcinogenic waste already are in the air, and the Syrian conflict has resulted in an air pollution emissions increase of up to 20 percent that caused significant degradation of air quality.

Studies show, for example, that the incidence of asthma runs 50 percent higher in Lebanon than in Europe and the United States. Environmental activists report higher incidence of cancer and respiratory illnesses, birth defects, and surface water and soil pollution linked to an existing incinerator at Dhour Shweir, and oppose waste incineration as a solution to Lebanon’s decades-long and growing problem.

The air quality plan offers more optimistic scenarios, with an emphasis on recycling, composting and other waste stream interventions to reduce volume, but it also relies heavily on Refuse Derived Fuel (RDF) solutions. Technically, RDF used in kilns is considered a “co-incineration” process that involves “much stricter requirements (including waste delivery, storage, pre-treatment, waste feeding and flue gas cleaning) in order to ensure sound environmental performance,” the European Union-funded plan says. Lebanon already admits its weak regulatory environment, with no clear indication it will change.

In November 2017, three academics at the American University warned that European-style waste incineration technology won’t readily transfer to Lebanon because of cultural and infrastructure differences. At 52 percent, more than half of Lebanon’s waste is organic and shouldn’t be burned. The plastic, paper and other materials need to be recycled instead, they added. And the pollution that waste incineration will generate will have adverse health impacts for an estimated 500,000 people in Beirut.

In December 2017, the international NGO Human Rights Watch released a 67-page report on Lebanon’s waste management crisis that underscored the public health impacts and appealed to Beirut to at last develop a long-term strategy. “As If You’re Inhaling Your Death” also exposed shocking details about the risks of rural burning because Lebanese officials focus only on the urban areas of Beirut-Mount Lebanon.

“Discussions for a long-term solution have centered around the use of incineration plants, however public health experts and environmental activists have raised concerns about the use of incineration plants as a long-term solution in Lebanon, citing concerns about the lack of a waste management framework, independent monitoring, emissions, and the high cost of incineration,” the HRW report said.

Meanwhile, a draft law sent to parliament in 2012 to establish a national Solid Waste Management Board under the Ministry of Environment has never been passed, officials fail to enforce existing environmental laws, and the burning continues. The two landfill sites expected to stay open until 2020 now are expected to be at capacity in 2018, and they are the subject of activist lawsuits filed in 2016.

Human Rights Watch, Greenpeace and other international NGOs have championed the cause of the Lebanese as an environmental and health issue, but note that the trash crisis is a human rights issue as well. They’re now being led by Lebanese activists seeking to ensure a sustainable future, and end the government’s practice of managing waste from one crisis to the next without implementing a strategy.

Their work is forcing politicians to take environmental concerns more seriously, and to discuss their plans publicly and with transparency. Yet Lebanese activists and journalists remain frustrated by the ineffective leadership and the lack of communication with citizens about future directions and risks, while the health and environmental crisis continues unabated. The garbage protests that began in 2015 have evolved into stronger organizations but without real change from an unresponsive government.

"This commitment is nice, but a lot of NGOs do what the state should be doing," journalist Kareem Chehayeb told Deutsche Welle in late December 2017. "My concern is if more NGOs become active, they will do the job that the government should be doing. We pay taxes for it, and the taxes shouldn't channeled away from that. The government has a responsibility."